Notice of Donation to Birds Queensland

I hereby notify you of my donation to your organization as follows:

Type of donation

To Birds Queensland Organisation
To Research Fund

Your details

Name

Postal address
(house/unit number and street, or PO box)
(Suburb / town and state)
Postcode:

Phone or mobile number (Optional)

Email Address (This is only required if you would like the receipt emailed to you)

Payment

Please select one of the payment options:

A cheque will be mailed to: The Secretary, Birds Queensland, PO Box 3784, South Brisbane BC, Qld 4101
An EFT or over the counter deposit has been made to:

Account Name: Queensland Ornithological Society Inc
BSB: 034-002
Account No: 259935

The details of my bank deposit are:
Bank through which the payment was made:

Date of payment (dd/mm/yyyy):

Amount of payment:
$
Reference used. This should be the member's name or bank reference number:

Form validation

Please enter the characters at right (case sensitive):  

        

[top of page]